Chapter 1: Image Analysis, Exams of Radiography

Chapter 1: Image Analysis Chapter 1: Image Analysis

Typology: Exams

2023/2024

Available from 06/23/2024

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Chapter 1: Image Analysis
Why Image Analysis? -
*The purpose of image analysis is to teach technologists how to:*
-Evaluate projections for acceptability
-Determine how to improve positioning and technical skills before repeating a projection
-Continually improve skills
It takes only __________ of rotation
to affect the appearance of the lungs -
2 to 3 degrees
The normal heart shadow will occupy ____________________ of the transverse dimension of the
thorax. -
slightly less than 50%
An optimal image of each projection demonstrates all the most desired features, which include the
following: -
-Demographic information (e.g., patient and facility name, time, date)
-Correct markers in the appropriate position without superimposing volume of interest (VOI)
-Desired anatomic structures in accurate alignment with each other
-Maximum geometric integrity
-Appropriate radiation protection
-Best possible contrast resolution, with minimal noise
-No preventable artifacts
Adjusting for Poor Display -
-Poorly displayed projections need to be adjusted before being sent to the picture archival
and communication system (PACS)
-Inaccurate manipulation can result in the right and left sides getting confused
-The marker will provide clues to the patient's orientation with the IR for the projection
Display Stations Resolution -
refers to the maximum number of pixels that the screen can demonstrate
The display monitor must be able to display -
the same number of pixels as the digital system that acquired the image can display
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Chapter 1: Image Analysis

Why Image Analysis? - The purpose of image analysis is to teach technologists how to: -Evaluate projections for acceptability -Determine how to improve positioning and technical skills before repeating a projection -Continually improve skills It takes only __________ of rotation to affect the appearance of the lungs - 2 to 3 degrees The normal heart shadow will occupy ____________________ of the transverse dimension of the thorax. - slightly less than 50% An optimal image of each projection demonstrates all the most desired features, which include the following: - -Demographic information (e.g., patient and facility name, time, date) -Correct markers in the appropriate position without superimposing volume of interest (VOI) -Desired anatomic structures in accurate alignment with each other -Maximum geometric integrity -Appropriate radiation protection -Best possible contrast resolution, with minimal noise -No preventable artifacts Adjusting for Poor Display - -Poorly displayed projections need to be adjusted before being sent to the picture archival and communication system (PACS) -Inaccurate manipulation can result in the right and left sides getting confused -The marker will provide clues to the patient's orientation with the IR for the projection Display Stations Resolution - refers to the maximum number of pixels that the screen can demonstrate The display monitor must be able to display - the same number of pixels as the digital system that acquired the image can display

Typically, the technologist's workstation has _____________ than the radiologist's display monitor - less resolution Markers - -Are radiopaque -Place on IR or tabletop when able (avoids distortion) -Place marker on lateral side CLEAN OFTEN AND REPLACE TAPE Long Bone Imaging - -XR beam will diverge as soon as it exits the tube -Extend collimation 1-2 inches beyond each joint space -Can place IR diagonally for better coverage A small collimated border: - -Clearly delineates VOI -Decreases radiation dosage -Improves visibility of recorded detail -Reduces histogram analysis errors The only time a small collimated border rule does NOT apply: - The only time that this rule does not apply is when the entire IR must be used to prevent clipping of needed anatomy, as with chest and abdominal projections -Be confident that the IR coverage will be sufficient, even though the light field appears small Rotating the Collimator Head - -Rotating just the collimator head does not affect the alignment of the beam with the grid -Can reduce radiation exposure and is an example of radiation protection Most routines require two views (AP/PA and lateral) because: - -Superimposed anatomic structures -Localize lesions or foreign bodies -Determine alignment of fractures or dislocations -When imaging joints a 3rd view is added (oblique) Off-Centering -

When two adjoining bones are perpendicular to each other: degree of flexion is 90 - Joint Spaces and Fracture Lines - -For an open joint space or fracture line to be demonstrated, the central ray must be aligned parallel with it -Failure = closed joint or poorly visualized fracture Repositioning for Repeat Projections - -Identify the two structures that are mispositioned -Determine which of the identified structures is positioned farthest from the IR -Determine the direction in which the structure situated farthest from the IR must move to be positioned accurately with respect to the other structure -Determine the number of inches or centimeters that the two mispositioned structures are off on the projection -Estimate how much the structure situated farthest from the IR will move per 5 degrees of angle adjustment placed on the CR Sharpness - Clarity of the anatomic lines that are displayed in the projection and by the degree of blur the details demonstrate. Low blur= - high detail sharpness Factors that affect sharpness: - -Focal spot size: smaller focal spot = better detail -Distances: Longer SID, shorter OID -Motion: Patient movement - voluntary or involuntary -Spatial resolution: Matrix size and size of the pixels within the matrix Focal spot size - smaller focal spot = better detail Distances - Longer SID, shorter OID Motion - Patient movement - voluntary or involuntary

Spatial resolution - Matrix size and size of the pixels within the matrix Radiation protection factors that should be evaluated to provide projections that can be obtained by following the ALARA philosophy include: - -Effective communication -Immobilization devices -Source-skin distance (SSD): at least 12 inches -Pregnancy -Gonadal shielding Make sure to do all of these things for protection: - -Shielding of radiosensitive cells not within the primary beam -Collimation -Exposure factors to minimize patient exposure -Automatic exposure control (AEC) backup timer Things to avoid: - -Avoiding dose creep -Anatomic artifacts -Personnel and family members in room during exposure